New standards help both health care professionals and patients manage opioid use

today released three standards outlining what quality care looks like where opioid use is concerned.

Called quality standards, they offer direction to health care providers and patients on when to use opioids - and the non-opioid treatments to

consider first  for people with acute pain (due to things like a broken bone or surgery) or chronic pain (commonly caused by arthritis or lower back pain).

The third standard outlines how to treat people with an opioid use disorder or addiction. There were 1,053 opioid-related deaths in Ontario from January to October 2017, compared with 694 during the same time period in 2016. People with opioid addiction have a mortality rate of 10 times more than the general population.

Data recently released in two Health Quality Ontario reports also shows that nearly two million people in Ontario fill prescriptions for opioids every year - translating into one in every seven Ontarians, or 14% of the province's population  and more than 40,000 Ontarians were newly started on high doses of prescription opioids in 2016. This, despite evidence that those who receive prescription opioids at higher than recommended doses are several times more likely to suffer an overdose or become addicted compared to those on lower doses.

Quality standards outline what high-quality care looks like for conditions where there are large variations in how care is delivered, or where gaps in access to care exist  like with conditions where opioids are being prescribed. They are based on the best available evidence and are developed in consultation with experts and patients with lived experience. They also include recommendations on proven supports that health care professionals can use to address gaps and barriers to care.

"There are many options available to health care providers to improve the health of people in pain, making it challenging to know what the best plan of action should be," says Joshua Tepper, president and CEO, Health Quality Ontario.

"Opioids play an important role in managing pain, but we also need to minimize the harm that can be caused from these medications, including the symptoms that come with addiction, opioid overdoses and death. In addition, we need to help patients who have an opioid use disorder and offer them evidence-based care. The quality standards released today will ensure patients with acute pain, chronic pain and an opioid disorder receive the highest quality of care. They have the potential to save a lot of lives and prevent enormous suffering."

The quality standards also offer guidance to health care professionals on how to not suddenly discontinue prescription opioids so patients do not turn to street sources.

In recognition of increasing opioid-related deaths, the Ministry of Health and Long-Term Care launched a comprehensive strategy in 2016 focused on opioid prescribing and monitoring, improving access to pain treatment, and enhancing addictions supports and harm reduction. These three standards support this provincial plan and other efforts.

These standards of care will be put into action through coordinated efforts with a number of health care organizations who are providing health care providers with customized data, tools and additional supports to help them help patients manage their pain.

"The hope is these standards will enable health care professionals to better identify addiction and manage the potential harmful consequences of long-term opioid use," says Sheryl Spithoff, a family physician, addiction medicine physician at Women's College Hospital, and one of the chairs of the committees advising Health Quality Ontario on the creation of these standards. "They are also designed to create an environment where patients feel comfortable discussing their opioid use without fear of judgement, and to explore all pain management solutions that are in their best interest."

These three opioid standards are part of Health Quality Ontario's broader quality standards program. Other recent topics include hip fracture, major depression and wound injury. For more information about the quality standards program visit: http://www.hqontario.ca/Evidence-to-Improve-Care/Quality-Standards.

About Health Quality Ontario
Health Quality Ontario is the provincial advisor on the quality of health care. With the goal of excellent care for all Ontarians, Health Quality Ontario reports to the public on how the system is performing, develops standards for what quality care looks like, evaluates the effectiveness of health care technologies and services, and promotes quality improvement aimed at sustainable positive change. Visit www.hqontario.ca for more information.

SOURCE Health Quality Ontario

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